Prevalence of Salmonella and Shigella Species among Underfive Children and Antibiotic Resistance Patterns at Jimma University Medical Center and Serbo Health Center, Southwest Ethiopia

Abstract

Introduction: Salmonella and Shigella species are common causes of bacterial diarrhea from mild to severe forms of intestinal tract infection. Worldwide, an estimated 21 million cases of gastroenteritis are due to Salmonella, resulting in 200,000 deaths each year where 80% of deaths occur among children under-five years of age. Shigella species is the leading pathogen among the top six attributable pathogens causing childhood diarrhoea. Objective: To determine the prevalence of Salmonella and Shigella Species among under-five children and antibiotic resistance patterns at Jimma University Medical Center and Serbo Health Center, Southwest Ethiopia from February 17 to June 30 15/2017. Methods: Cross-sectional study design was used to collect data. The stool samples were inoculated on MacConkey agar, xylose lysine dextrose agar and incubated aerobically at 37oC for 18 to 24 hrs. The same samples were plated onto Selenite F broth for enrichment of Salmonella species. All positive stool cultures were identified and characterized on the basis of morphology, cultural characters and biochemical tests. The antibiotic susceptibility testing using Kirby-Bauer disk diffusion against commonly used antibiotics was done on Mueller Hinton agar. The results of the susceptibility tests reported as susceptible, intermediate or resistant according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) guideline. Results: From 348 stool samples screened, 39 samples were positive for bacterial growth. The overall prevalence of Salmonella and Shigella species was 5.2 % and 6.0% respectively. Frequently isolated Salmonella species was Salmonella typhi (44.5%) while presumptive identification of Shigella species showed 57.1% was Shigella flexneri. About 76.2% of Shigella species and 66.7% of Salmonella isolates were multidrug resistant. Shigella and Salmonella species showed highest frequency of drug resistance against ampicillin (100%, 88.9%), cefuroxime (85.7%, 72.2%) respectively. Conclusion: Salmonella and Shigella species remain significant causes of bacterial diarrhea. Higher level of drug resistance observed in the present study. Fluoroquinolones and ceftriaxone are still treatment of option for Salmonella and Shigella species. Recommendation: This study recommends health facilities to regularly update the treatment guideline based on national and local antimicrobial susceptibility patterns of organisms and it also recommends adopting of stool culture with antimicrobial susceptibility testing prior to treatment.